Flexible endoscope-assisted endonasal transsphenoidal surgery for pituitary tumors

T. Kawamata, S. Kamikawa, Hiroshi Iseki, T. Hori

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

We have performed rigid endoscope-assisted endonasal transsphenoidal microsurgeries for pituitary tumors in 230 patients. Recently, we further introduced the use of a flexible endoscope to inspect the tumor bed and suprasellar structures more extensively. We report our experience with the flexible endoscope in endonasal transsphenoidal surgery for pituitary tumors. The endoscopes were used to complement the microscope in visualization. The flexible endoscopes were used in 34 recent cases with suprasellar and/or lateral tumor extension. During or after removal of the main tumor bulk, the flexible endoscope together with a rigid endoscope was used to inspect the tumor cavity, especially at the blind spot of the microscope. Despite limited resolving power, in all the 34 cases the flexible endoscope was a highly efficient tool permitting extensive visualization of almost the whole surgical area, even in narrow surgical fields and spaces not visible with an operating microscope or a rigid endoscope, and allowing continuous change of viewing angle. The residual tumor situated laterally or in the suprasellar areas that could not be reached and was impossible to remove by a rigid endoscope could be dissected and extirpated under a flexible endoscope using grasping forceps in 5 patients with pituitary adenoma and all the craniopharyngioma cases. The flexible endoscope may be more efficient in the lateral and suprasellar areas than the rigid endoscope in compensating for the narrow surgical field in endonasal pituitary surgery, despite its limited resolving power. Surgeons should make the best use of the advantages of each instrument.

Original languageEnglish
Pages (from-to)208-210
Number of pages3
JournalMinimally Invasive Neurosurgery
Volume45
Issue number4
DOIs
Publication statusPublished - 2002 Dec
Externally publishedYes

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Endoscopes
Pituitary Neoplasms
Neoplasms
Craniopharyngioma
Microsurgery
Optic Disk
Residual Neoplasm
Surgical Instruments

Keywords

  • Endonasal
  • Flexible Endoscope
  • Pituitary Tumors
  • Rigid Endoscope

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Flexible endoscope-assisted endonasal transsphenoidal surgery for pituitary tumors. / Kawamata, T.; Kamikawa, S.; Iseki, Hiroshi; Hori, T.

In: Minimally Invasive Neurosurgery, Vol. 45, No. 4, 12.2002, p. 208-210.

Research output: Contribution to journalArticle

Kawamata, T. ; Kamikawa, S. ; Iseki, Hiroshi ; Hori, T. / Flexible endoscope-assisted endonasal transsphenoidal surgery for pituitary tumors. In: Minimally Invasive Neurosurgery. 2002 ; Vol. 45, No. 4. pp. 208-210.
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